This invention generally relates to safety features for a hospital bed with movably mounted guard rails and, more particularly, to guard rail actuated safety apparatus for reducing the risk of negligent use or non-use of the guard rails to prevent falling injuries to patients.
Conventional hospital beds are often provided with guard rails to prevent injuries to patients from falling out of bed. Such falling injuries can be serious, if not fatal. Catastrophic liability for the hospital or other health facility responsible for the good care of the patient can also result because of the high level of care which is legally expected of them. In addition, it is well known that the risk of serious injury caused by a fall from a hospital bed is greater for the typical patient in a hospital than for a healthy person. Hospital patients are often in a fragile condition and are less able to withstand even the slightest injury. The height of the top of the mattress of a hospital bed and thus the extent of the drop is significantly greater than in a conventional bed. Also, in order to facilitate ease of cleaning and rolling movement of beds and other equipment, many hospital floor surfaces are only thinly carpeted, if at all.
Such guard rails are often movably mounted to the bed frame to enable them to be lowered to an inoperative position. Movable mounting of the guard rails is required to facilitate access to the patient, to install and remove the patient and to periodically change soiled sheets, mattress covers, blankets and the like. There are numerous methods of movably mounting the guard rails to the bed frame which are known. Some guard rails are mounted to slide up and down, such as shown in U.S. Pat. Nos. 2,734,104 of Gollhofer issued Feb. 7, 1956 and 3,012,255 of Diehl issued Dec. 12, 1961; some are mounted for pivotal movement about an axis transverse to the elongate axis of the bed, such as shown in U.S. Pat. Nos. 3,336,609 of Taylor issued Oct. 15, 1974, 3,930,273 of Stern issued Jan. 6, 1976 and 3,840,917 of Taylor issued Aug. 22, 1967; and some are mounted for pivotal movement about an axis parallel to the bed such as shown in U.S. Pat. No. 4,509,217 of Therrien issued Apr. 9, 1985. Even though easily movable to an inoperative position, these guard rails are relied upon exclusively to protect the patient against falls off the bed.
Accordingly, potentially dangerous situations can develop when the movably mounted guard rails on a hospital bed are accidentally or inadvertently placed in, or allowed to remain in, a lowered, inoperative position. In some of these situations the guard rail is rendered or allowed to remain inoperable when it is most needed.
One dangerous situation potentially develops when the mattress covers or sheets of a bed with an immobile patient need to be changed. In such case, the patient is sometimes rolled onto his side away from the lowered rail, and the sheet is then loosened and tucked against the edge of the patient's body where it meets the mattress. The attendant then goes to the other side of the bed and rolls the patient onto his other side and off the tucked portion of the sheet to enable its removal. A new sheet is then installed in a reverse, but otherwise identical, fashion. During such a procedure, it is recommended for the attendant to only lower one side rail at a time and only while the attendant is standing at that side. However, if the attendant forgets or is not properly trained, it is possible for the attendant to actually roll the patient toward an unprotected edge of the mattress or to leave the side of the patient's bed in an unguarded condition.
In some situations, and often emergency situations, the bed, being mounted on wheels, casters or the like, is used to transport the patient from different locations in the hospital. During emergencies it is often necessary to lower one or both rails to gain access to the patient immediately prior to moving the bed. Again, although recommended procedure is to raise the guard rail to an operative position while the bed is being rolled across the floor, it is possible for the procedure to not be followed even though the momentum forces, such as caused from the bed being rolled around a corner or inadvertently being jammed against an object, increase the chances of the patient moving toward an unprotected edge of the mattress or other patient support.
The danger of a patient losing balance and falling toward an unprotected edge while sitting up in bed, for instance, is increased when the profile of an articulatd bed is being adjusted, lowered or raised or when a rotary kinetic therapy bed, such as shown in U.S. Pat. No. 3,434,165 of Keane, issued Mar. 25, 1969, is operated. Again, although the safest procedure is for both guard rails to be raised to an operative position by the attendant, the attendant may forget to do so or may not be present upon occurrence of the adjustment or other movement of the patient support.
It is also possible for a rail to fall into an inoperative position due to mechanical failure of a releasable rail locking mechanism or due to inadvertent or unintentional release of the guard rail by the patient. If an attendant forgets to raise the rail after administering a shot or the like, the patient can remain unprotected from falls off the edge of the bed while semiconscious or asleep.
While there has been an attempt to provide an alarm when a patient tries to crawl over the rails without lowering them, such as shown in U.S. Pat. Nos. 3,781,843 of Harrison et al., issued Dec. 25, 1973 and 4,067,005 of Levy et al., issued Jan. 3, 1978 for some time there has been no solution to the potentially severe risk presented to patients in hospital beds lacking any protection against negligent misuse of, negligent non-use of or accidental failure of hospital bed guard rails.
Several locks, such as shown in U.S. Pat. No. 3,846,854 of Bryant issued Nov. 12, 1974, and the alarm systems of the patents of Harrison and Levy et al., above, are directed against restraining the patient against lowering the guard rail or warning of the patient's attempts to climb over the guard rail. However, they fail to even address the equally serious and potentially greater risk to the patient and resultant liability from negligent use of the guard rail by attendants.